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Simple Strategies to Help People Make Better Food Choices: Can
Supermarkets Help?

By Julia Bird

Choice can be our downfall in selecting foods for a healthy diet. Factors such as attractive packaging, price, expected sensory gratification, convenience, and familiarity with the product can all override healthier food choices. Many professionals working in nutrition and public health are interested in how we can help the average consumer to select foods that are suitable to avoid nutrient deficiencies and maintain a healthy weight. Individual product choices can also be swayed by product placement and promotion at the point of sale. This has been used traditionally to encourage consumers to choose a particular brand of food, however Foster and co-workers also recently investigated whether this technique could be used to increase sales of healthier alternatives in supermarkets that serve ethnically diverse and low-income communities.

The authors used a cluster-randomized design and selected 8 US supermarkets located in Philadelphia, Pennsylvania, and close by in Wilmington, Delaware. 15 top-selling food and beverage products from 11 categories were selected and the authors investigated whether there were healthier alternatives (based on fewer calories per serving) that were produced by a national manufacturer, consumed by families, and also were cost-neutral or less expensive than the top-selling product. The authors found suitable alternative products meeting these criteria in 4 categories: milk, ready-to-eat cereal, frozen meals, and beverages.

The supermarkets were randomized to either control or intervention groups. Over a period of 6 months, the intervention supermarkets used mainly placement but also promotional techniques to try and increase sales of healthier products. There is a science to product placement on supermarket shelves (see interesting review from Larson). The strategies used to increase sales of healthier products included:

* Increasing the number of “facings” of healthier products, e.g. many products are placed as a single stack of products, but this can be increased to improve exposure to the product.

* Placing healthier products in prime positions in the display cabinets – at eye-level, in the middle of the shelf, for example.

* Placing call-out signs for healthier products.

* Cross-promoting, for example placing a display of healthier ready-to-eat cereal close to the milk.

* Taste-testing healthier products.

Promoting the healthier products according by highlighting the nutritional content was not part of the strategy. The control supermarkets did not change their strategy regarding the promotion of healthier products, and were used to control for both the effect of the intervention, and seasonal differences in product choices. Sales data were used to gauge the effect of the intervention.

For milk, for which consumption decreased during the study, the intervention appear to help sales of skim milk remain stable and increased consumption of milk containing 1% fat. The intervention increased sales for 2 of the 3 frozen meals compared to control stores, with no changes in the third meal. Sales of water on the shelf declined during the study, however the decline was less in the intervention stores. For beverages in the cooler placed near the checkout, sales of water increased compared to regular soft drinks in the intervention stores. There were no changes in sales of healthier ready-to-eat cereals between the intervention or control stores. The authors also noted that it was difficult to encourage consumers to choose diet soft drinks over regular soft drinks: they did note that water may be an acceptable alternative to regular soft drinks. The lack of effect on cereal sales was attributed to brand loyalty and lack of impulse buys in the cereal category (apparently, 60% of supermarket sales are impulse buys, according to Karolefski.

Malnutrition, including low intakes of critical nutrients and overnutrition, are problems are multifactorial in nature. Supermarkets supply food to many people (in the US, 5.7% of disposable income is spent at the supermarket, according to FMI) and therefore can have considerable power in affecting food product choices. Simple placement strategies at the point of sale could help nudge individuals to purchase healthier foods.